Kids' ER Visits Down After Cold Medicine Withdrawal

MONDAY, Nov. 22 -- Three years after nonprescription infant cold medicines were taken off the market, emergency rooms treat less than half as many children under 2 for overdoses and other adverse reactions to the drugs, a new U.S. government study shows.

A voluntary withdrawal of over-the-counter cough and cold medicines for children aged 2 and under took effect in October 2007 because of concerns about potential harm and lack of effectiveness. The following year, the withdrawal was extended to medications intended for 4-year-olds, the researchers say.

"I think it's good that these products were withdrawn, but it's not going to take care of the entire problem," said lead researcher Dr. Daniel S. Budnitz, of the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention (CDC).

Since more than two-thirds of these emergency department visits were the result of young children getting into medicines on their own, problems are likely to continue, he said.

The report is published online Nov. 22 in Pediatrics.

For the study, Budnitz's team tracked visits to U.S. hospital emergency departments by children under 12 who were treated for adverse events tied to over-the-counter cold medications in the 14 months before and after the withdrawal.

Although the total number of visits remained the same before and after the withdrawal, among children under 2 these visits dropped from 2,790 to 1,248 -- more than 50 percent, the researchers found.

But, as with emergency department visits before the withdrawal, 75 percent of cases involving cold medications resulted from children taking these drugs while unsupervised.

Perhaps some parents are giving their young children cough and cold medications intended for older children or adults, he said.

"The lesson for parents is, don't give cough and cold medicines to your infants," Budnitz said. "Also, keep all medicines up and out of the way of children," he said.

To help prevent children from getting into medications, the CDC is working with manufacturers to get safer caps on medicine bottles, Budnitz said.

Commenting on the study, Dr. Andrew Racine, chief of general pediatrics at Montefiore Medical Center in New York City, stressed that over-the-counter cough and cold medications are not intended for children under 4 years.

"The efficacy studies for these things are not very robust, and the potential bad effects have been well-documented," he said.

The withdrawal of these drugs proves that a public health solution can be effective, Racine said.

Racine concedes that young children who suffer from colds can make everyone in the home uncomfortable. "An 18-month-old that's up all night coughing, sneezing, and just miserable is very disruptive to a household," he said.

But there are safer ways to help your child deal with a cold, he said.

If a fever causes young children discomfort, you can give them Tylenol (acetaminophen), Racine said. "I tell parents not to be doing that at the least sign of fever, because a little fever is actually good. It helps make it difficult for the virus to replicate," he said.

A humidifier can relieve congestion, Racine said. Nasal saline drops and a bulb syringe to suck out mucus can provide some relief to infants with congestion, he added.